NPI 1164076790

Home Away Residential Services LLC

Organisation Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility Woodbridge, VA

Practice location

Address: 4304 Eldorado Dr, Woodbridge, VA 22193-2716
Phone: (301) 807-6184
Fax: (301) 464-0225

Authorised official

Name: Nkenglefe Felix Atangcho
Title: Owner
Phone: (301) 807-6184

Registered specialties

Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility Primary

Residential Treatment Facilities Taxonomy 320900000X

Other Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities providers in Virginia →

Registry record

NPI: 1164076790
Entity type: Organization
NPI issued: 31 Jul 2019
Record last updated: 31 Jul 2019

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.